乌司他丁联合小剂量甲基强的松龙在急性呼吸窘迫综合征临床应用研究

Clinical Study of Ulinastatin Combined with Low-dose Methylprednisolone on Patients with Acute Respiratory Distress Syndrome

目的:评价乌司他丁联合小剂量甲基强的松龙对急性呼吸窘迫综合征的治疗效果。方法:将56例急性呼吸窘迫综合征患者随机分为A、B两组各28例,A组用乌司他丁联合甲基强的松龙治疗,B组单用甲基强的松龙治疗;观察治疗前、后患者呼吸频率、动脉血气、呼吸力学、肺泡灌洗液TNF-α和IL-10、乳酸的变化及机械通气时间、ICU住院时间、急性肺损伤评分和APACHEⅡ评分。结果:治疗后两组患者呼吸频率、动脉血气、呼吸力学、肺泡灌洗液TNF-α和IL-10、乳酸的变化及机械通气时间、ICU住院时间和APACHEⅡ评分等指标较前均有改善(P均<0.05),且A组较B组改善明显(P均<0.05)。结论:乌司他丁联合小剂量甲基强的松龙对急性呼吸窘迫综合征有良好的治疗作用。

Objective:To assess the clinical study of ulinastatin combined with low-dose methylprednisolone on patients with acute respiratory distress syndrome.Methods:Fifty-six patients with ALI/ARDS were randomly divided into control group and treatment group(n=28).Both groups were given low-dose methylprednisolone,and treatment group were additionally treated with ulinastatin.The differences between two groups were compared in respiratory rates,arterial blood gas,breathing mechanics ventilator,the TNF-α and IL-10 levels in BALF,lactic acid,Murray lung injury score,the duration of mechanical ventilation,ICU admission time,APACHEⅡscore before and after treatment.Results:After the treatment,two groups of patients with respiratory rates,arterial blood gas,breathing mechanics ventilator,the TNF-α and IL-10 levels in BALF,lactic acid and the duration of mechanical ventilation,ICU admission time and APACHEⅡscore are improved significantly(P<0.05),but the improvement of all these indexes were more marked in A group(P<0.05).Conclusion:Effects of ulinastatin combined with low-dose of methylprednisolone on acute respiratory distress syndrome has good therapeutic effects.